One of the things I sometimes miss about medicine is being able to talk to my patients. Not talk as in take history and explain procedures, get consent, etc. No, I mean sit down and really talk , as in what's your job, how're you coping with your condition(s), why exactly aren't you taking your meds, etc. I used to do this from time to time, especially when I ran the SGH gastroenterology MO clinics way back in 2000. We had these sessions maybe once a week, seeing simple referrals for Hepatitis B or non-specific abdominal pain. I loved the old fogies the most. And in the wards, SGH haematology offered many opportunities to know our patients well, due to the chronic nature of their illnesses ( e.g. leukemia, lymphoma, aplastic anemia ), which necessitated repeat admissions and long hospital stays. We got to know their families, favourite foods, assorted idiosyncracies. On a more medical aspect, we were even able to memorize their drug allergies, blood groups and chemo regimens.

Such leisurely communication isn't possible in the A&E setting, but this evening, I saw a Malay man in his late 50s who was diagnosed with stomach cancer a year ago, but is now undergoing chemotherapy for recurrence. Before discharging him, I asked if he needed an MC, but his wife told me he was retrenched. Usually, I don't ask for details, but I liked this couple -- soft-spoken, very pleasant -- and queried if he lost his job before or after the CA was diagnosed.
"After," she replied. "They sacked him because he couldn't work anymore."
"But he couldn't work because of the cancer, right?" I commented. This wasn't new to me, having come across quite a few similar cases these past few years. In 2002, I met a guy in his 40s with an acute myocardial infarct ( ie. medical jargon for heart attack )over at NUH, who was promptly relieved of his duties soon after he was admitted for treatment. I could never fully understand how employers can do such things without getting into any trouble. But then, I'm not a lawyer, so I can't say if this constitutes some kind of "wrongful termination" situation. Seems rather unfair to the patient if s/he has medical benefits to begin with, then gets the sack when diagnosed with something moderately serious yet treatable, at least in the short term. Shouldn't there be a "probation period" in the interim, while the patient is in the convalescent phase, with a proper review later on when s/he returns to work? Sure, cancer can be severely debilitating, hence the inability to perform at one's job. But many people with heart attacks recover well and continue to lead normal lives. And yet, this man wasn't even given a chance. :(

Will be staying in consult for the night this time round, as one of my fellow MOs-on-call has sinusitis and requested to run resus for the entire shift. Let's hope this is the night we have minimal attendances -- at least in consult!

The MTVAsia Awards show wasn't too bad this year in terms of star turnout, I suppose. Performances-wise, however, I think last year's was a lot better. Granted, the Black-Eyed Peas were the closing act and caused a lot of excitement. But they've never sounded good live, and last night was no exception. Pity that. Stacie Orrico was a little shaky, the Sugababes too, and Michelle Branch, t.A.T.u, surprise guest Mariah Carey and Blue didn't sing! What a travesty! Carey, for your info, appeared for a total duration of maybe 3 minutes, smiling her little plastic smile, decked out in a bright pink slinky gown, accepting her MTVAsia Lifetime Achievement Award ( Lifetime achievement? What is she, in her 30s? ). And speaking of pink and slinky, get a load of Michelle's eye-popping top, which threatened to turn into another Janet Jackson Nipplegate all on its own. Interesting how the show's producers let that get by.
My pick for most enjoyable performance of the night? Unexpectedly, it's Gareth Gates' duet with Siti Nurhaliza on "Say It Isn't So". I'm not a Gates fan, but was sufficiently impressed with his rendition of an Elvis song during a recent telecast of the Royal Variety Performance on local TV. He's always been too toothy and shrill-voiced for my liking, but I found myself humming along and nodding appreciatively during the power-notes. Nurhaliza, in particular, has an admirably strong voice, and the collaboration was quite the show-stealer.

Another show I'd like to talk about -- before I sneak off for my nap :) -- is "Survivor All-Stars". The latest loss is Jenna Morasca, who won on "Survivor: Amazon" through unbelievably, dumbfoundingly good luck ( Rob Cesternino deserved the trophy in that one, but Matt the machete-obsessed psycho couldn't risk losing, so in the end, he picked Jenna to join him in the final two and lost to her, har har ). Anyhow, Jenna's mother's battle with cancer was already a well-known issue in the Amazon, and the story ended quite happily when she received news that her mom was responding to treatment. This time, though, Jenna left her side yet again, then started to brood and cry 10 days into the competition, saying she "had a feeling" her mom was getting worse. She subsequently bowed out, saving the rest from having to go to tribal council, but my question is: if she's such a loving daughter ( and an only child to boot ), why THE HECK did she bother returning for a second chance at being marooned on an island, cut off from all contact with her sick mother? Yes yes, her mom wanted her to do it, but c'mon, even she should've known better.
Anyway, 8 days after she rushed home, her mom passed away. But all I can think about is how Jenna wasted 10 perfectly good days with her during her last moments on Earth. Even another million isn't worth this .